Forms
NMSIIS Decision to Remove Record
Immunization - Form
December 30, 2021
This form is used by a patient/parent/legal guardian to remove records from the New Mexico Statewide Immunization Information System.
NMSIIS Decline to Participate Form
Immunization - Form
December 30, 2021
This form is used by a patient/parent/legal guardian to decline to participate in the New Mexico Statewide Immunization Information System.
VFC Vaccine Administration Form (Part B)
Immunization - Form
October 1, 2021
This form allows you to provide immunization information for entry into NMSIIS.
Adult Vaccine Consent Form
Immunization - Form
October 1, 2021
This form may be used by adult patients aged 19 and older to provide vaccination consent to a healthcare provider.
Got Shots Fillable Form
Immunization - Form
July 1, 2021
Got Shots Fillable Form
Got Shots? Fillable Form - Eng
Got Shots? Fillable Form - Esp
COVID-19 Vaccine Consent Form English
Immunization - Form
March 25, 2021
This form should be used as Consent for COVID-19 Vaccinations
COVID-19 Vaccine Consent Form Spanish.
Immunization - Form
February 25, 2021
This form should be used as Consent for COVID-19 Vaccinations